Menopause & Rage: Symptoms, Causes, and Treatments

Mood changes are common during the menopause transition. Many women experience heightened feelings of sadness, overwhelm, or anger. Anger is a normal and necessary human emotion. It plays an important role in survival, motivation, and healthy self-expression. During the menopause transition, some women may experience marked increases in anger, sometimes referred to as “menopause rage.”

Compared to women, anger has traditionally been deemed a more socially acceptable characteristic in men.⁽¹⁾ Positioning menopause rage as a symptom in need of treatment can perpetuate the stigma surrounding women's expressions of anger. It also minimizes the influence of sociocultural factors, such as gender inequality in the workplace or negative stereotypes about aging, which can contribute to growing anger and frustration during this stage of life.⁽²⁾

With these factors in mind, if the physical and emotional effects of increased anger during menopause are impacting daily life, understanding the causes of these mood changes can help women who may be looking for resources and professional support.

What is menopause rage?

Many women approaching menopause report that they don’t feel like their normal selves. Some women associate this feeling with irritability or difficulty calming down. A rush of anger or rage has also been associated with women’s experience of not feeling like themselves during perimenopause.⁽³⁾

Menopausal rage is described as bouts of heightened anger that occur during perimenopause or menopause. While general anger is a natural response to stress, menopausal anger can sometimes be more intense and is believed to be primarily related to hormonal fluctuations.

Causes of Menopausal Anger

Menopausal anger may be linked with declining levels of steroid hormones, particularly estrogen and progesterone. It may also be influenced by bothersome vasomotor symptoms as well as lifestyle factors specific to this phase of life. 

Hormonal Fluctuations

Estrogen is the primary steroid hormone in women and is responsible for sexual and reproductive health. Estrogen affects different brain areas, including the hippocampus, prefrontal cortex, and amygdala, all of which play a role in emotion regulation.⁽⁴⁾ Among its many functions, progesterone is another steroid hormone that supports endometrial health during pregnancy and ovulation.⁽⁵⁾ 

Estrogen and progesterone imbalances that occur during the menopause transition can have psychological effects. Decreases in these hormones can impact the production of neurotransmitters, particularly serotonin, which is believed to influence mood and affect behavior, cognition, and emotion regulation.⁽⁶⁾ 

Vasomotor Symptoms of Menopause

Increased anger may also be influenced by vasomotor symptoms. Many women experience night sweats and hot flashes during menopause. Flushes of heat and excessive sweating can cause physical discomfort, sleep disruptions, and daytime fatigue, all of which can exacerbate feelings of frustration or irritability. 

Lifestyle Factors

Many women report feeling more stressed during menopause, which may intensify feelings of anger. Stressors during this stage of life can include work pressures, family responsibilities, or partner stress.

Menopausal care has also traditionally been overlooked in the healthcare industry. Research shows that menopausal symptoms often go undocumented during primary care visits. Women may not receive treatment, with symptoms often being dismissed or downplayed as normal parts of aging. This lack of attention from the healthcare industry can make dealing with menopause all the more frustrating.⁽⁷⁾⁽⁸⁾

Perimenopause Rage: The Early Warning Sign

Perimenopause begins when a woman starts experiencing irregular periods and lasts an average of four years. It’s during this time when many women begin experiencing menopausal symptoms as hormone production declines. Therefore, women may first notice increases in anger during the menopause transition. Research shows that 70% of perimenopausal women report irritability as the main mood change experienced during this transitional time.⁽¹⁾ 

Women define irritability in different ways. In a study of Canadian women experiencing mood changes related to childbirth, menstruation, or perimenopause, researchers asked participants to rate and describe their experience of irritability. Some of the most common characteristics women associated with irritability include the following:⁽¹⁾

• Anger

• Annoyance

• Tension

• Hostility 

• Sensitivity (including to sound)

Women also reported that irritability often impacted their self-esteem or social life. Feelings of depression, vulnerability, as well as physical symptoms were also associated with the emotion, highlighting the need for professional support for women experiencing emotional changes during perimenopause and menopause.

Treatment Options for Menopause Rage

It’s important to take women’s emotional and physical symptoms into account when treating menopausal anger to reduce the risk of health problems. Research indicates that frequent bouts of anger may reduce vasodilation. This prevents blood vessels from widening, and people who experience recurrent anger may subsequently be more susceptible to heart disease.⁽⁹⁾

The following are treatment methods for addressing menopausal anger:⁽¹⁰⁾

• Bioidentical Hormone Replacement Therapy (HRT): Some research shows that patterns of estrogen fluctuations associated with irritability during the menopause transition differ from hormonal patterns related to depression, another common cause of mood change.⁽³⁾ Supplementing the body with hormones that decline during menopause may help mitigate mood swings.

• Cognitive Behavioral Therapy (CBT): This form of talk therapy involves recognizing emotional triggers and redirecting negative thoughts. This is the most common therapeutic approach used for anger management.

• Stress Inoculation Training (SIT): This is a subtype of CBT that focuses on developing coping skills in response to stress in order to build emotional resilience. Patients practice physical relaxation and mindfulness techniques in preparation for stressful situations.⁽¹¹⁾

• Family Therapy: If anger during menopause stems from family stress, family therapy can help patients and their loved ones navigate conflict and strengthen communication skills.

• Psychodynamic Therapy: Patients work with a mental health professional to process past experiences in order to identify underlying causes of emotional distress and better understand how they contribute to current behavioral patterns.

• Pharmacological Treatment: Certain mental health treatment medications may help regulate anger or rage, particularly if symptoms are related to a mental health disorder. A doctor or psychiatrist may recommend pharmacological treatment in combination with psychotherapy.^(12)(13) 

Coping Strategies for Managing Menopause Anger

Along with professional treatment, there are strategies women can implement to help with stress management during menopause. The following tips include lifestyle changes for menopause symptom management as well as strategies for strengthening emotion regulation skills:⁽⁶⁾

• Practicing Mindfulness Techniques: Breathing exercises, progressive muscle relaxation, or meditation practice can help individuals recognize physical sensations in the body, stay present in the moment, and keep stress levels low.

• Getting Regular Physical Activity: Getting 30 minutes of moderate-intensity exercise most days of the week can support physical health, boost memory, and reduce feelings of stress and anxiety.

• Maintaining a Healthy Diet: Eating plenty of vegetables, fruits, and whole grains while avoiding coffee and alcohol can help maintain a balanced mood.

• Practicing Healthy Sleep Habits: Night sweats can interrupt sleep, which may increase emotional reactivity during the day. While vasomotor symptoms are common during menopause, maintaining a consistent bedtime routine, wearing breathable pajamas, or keeping the house cool at night can support sleep health.

• Managing Daytime Hot Flashes: To reduce the physical discomfort of hot flashes, women may benefit from wearing lightweight clothing, avoiding spicy foods, and keeping a bottle of cold water or a portable fan on hand.

• Journaling: A journal can be a safe place to express emotions. Processing anger or frustration through writing may help mitigate reactivity during conflict. Some women may also find journaling helpful for identifying triggers or logging patterns of behavior.

When to See a Doctor for Rage During Menopause

Women don’t have to endure mood changes alone. If menopausal anger has begun to interfere with work, interpersonal relationships, or emotional well-being, it’s recommended to reach out to a doctor to discuss supportive treatment options. A healthcare provider may recommend mental health counseling, lifestyle changes, HRT supplementation, or a combination of these treatments. Women deserve to feel like themselves amid the physiological and emotional changes that occur during menopause.